Dorsal Capsuloplasty in Volar Subluxation of the Distal Radius

Koch, A.; Jong, Tijmen de

doi:10.1016/b978-1-4160-4083-5.00032-9

Fractures and Injuries of the Distal Radius and Carpus 2009

DOI: 10.1016/b978-1-4160-4083-5.00032-9

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Dorsal Capsuloplasty in Volar Subluxation of the Distal Radius

A. Koch¹,

Tijmen de Jong²

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2013

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“…17 Different procedures have been described for restoring stability of the DRUJ. These techniques can be grouped into the following categories -1.-a radio-ulnar tether, extrinsic to the joint, 18 -2.-an indirect radio-ulnar link consisting of an ulnocarpal sling or tenodesis, 19 -3.-direct reconstruction of the distal radio-ulnar ligament 2,3,17,20 and -4fixation of the disrupted TFCC to the fovea. 21 Koch and de Jong 17 observed dorsal instability of the DRUJ caused by isolated laxity of the dorsal capsule over the ulnar head originating from the DRUL, which was amenable for capsuloplasty.…”

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Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna

2013

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Background Dorsal instability of the distal ulna can lead to chronic wrist pain and loss of function. Structural changes to the dorsal radioulnar ligaments (DRUL) of the triangular fibrocartilage complex (TFCC) and the dorsal capsule around the ulnar head with or without foveal detachment can lead to volar subluxation of the distal radius e.g., dorsal instability of the distal ulna. Purpose Is to evaluate the post-operative results of reinstituting distal radioulnar joint (DRUJ) stability through reefing of the dorsal capsule and dorsal radioulnar ligaments, with and without a foveal reattachment of the TFCC. Methods A total of 37 patients were included in this retrospective study. Diagnosis and treatment was based strictly on dry wrist arthroscopy. In 17 patients isolated reefing of the DRUL and their collateral tissue extension was performed. In 20 patients an additional foveal reinsertion was performed. Postoperative results were evaluated with the DASH questionnaire, VAS scores, grip strength and range of motion. These findings were extrapolated in the Mayo wrist score. The two subgroups were compared. Results Mayo wrist scores of the whole population had a mean of 73. There was no difference between the group that was treated with reefing of the DRUL only and the group that was treated with a combined foveal reinsertion. Conclusion This relatively simple 'dorsal reefing' procedure, with foveal reinsertion when indicated, is a reliable method to restore volar-dorsal DRUJ stability with a significant decrease in pain sensation, good DASH scores and restoration of functional grip strength and ROM. Type of Study/Level of Evidence Therapeutic, Level IV.

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Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna

2013

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Dorsal Capsuloplasty in Volar Subluxation of the Distal Radius

Cited by 1 publication

References 30 publications

Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna

Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna

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